{"id":6,"date":"2023-07-10T21:17:13","date_gmt":"2023-07-10T21:17:13","guid":{"rendered":"http:\/\/qun.qsp.mybluehost.me\/contact\/"},"modified":"2025-01-31T17:19:30","modified_gmt":"2025-01-31T17:19:30","slug":"contact","status":"publish","type":"page","link":"https:\/\/cognitivetxsolutions.com\/staging\/7171\/contact\/","title":{"rendered":"Forms"},"content":{"rendered":"\n<div class=\"nfd-container nfd-px-base nfd-py-0 nfd-bg-accent wp-block-group alignfull has-white-color has-text-color has-link-color wp-elements-a39ba7ed9167b29c31cb49d44649b725 is-layout-flow wp-block-group-is-layout-flow\">\n<div class=\"nfd-text-md wp-block-group is-content-justification-right is-nowrap is-layout-flex wp-container-core-group-is-layout-d8784384 wp-block-group-is-layout-flex\" style=\"padding-top:32px;padding-right:0;padding-bottom:32px;padding-left:0\"><div class=\"wp-block-site-logo\"><a href=\"https:\/\/cognitivetxsolutions.com\/staging\/7171\/\" class=\"custom-logo-link\" rel=\"home\"><img loading=\"lazy\" decoding=\"async\" width=\"217\" height=\"121\" src=\"https:\/\/i0.wp.com\/cognitivetxsolutions.com\/staging\/7171\/wp-content\/uploads\/2024\/03\/IMG_0966.png?fit=596%2C333&amp;ssl=1\" class=\"custom-logo\" alt=\"Cognitive Tx Solutions Inc.\" srcset=\"https:\/\/i0.wp.com\/cognitivetxsolutions.com\/staging\/7171\/wp-content\/uploads\/2024\/03\/IMG_0966.png?w=596&amp;ssl=1 596w, https:\/\/i0.wp.com\/cognitivetxsolutions.com\/staging\/7171\/wp-content\/uploads\/2024\/03\/IMG_0966.png?resize=300%2C168&amp;ssl=1 300w\" sizes=\"auto, (max-width: 217px) 100vw, 217px\" \/><\/a><\/div>\n\n\n<h2 class=\"wp-block-heading\">vH<\/h2>\n\n\n\n<div class=\"wp-block-group is-content-justification-left is-nowrap is-layout-flex wp-container-core-group-is-layout-865ac6eb wp-block-group-is-layout-flex\"><nav class=\"has-background has-primary-background-color is-responsive items-justified-left md:nfd-order-2 wp-block-navigation is-content-justification-left is-layout-flex wp-container-core-navigation-is-layout-fc4fd283 wp-block-navigation-is-layout-flex\" aria-label=\"Header navigation\" \n\t\t data-wp-interactive=\"core\/navigation\" data-wp-context='{\"overlayOpenedBy\":{\"click\":false,\"hover\":false,\"focus\":false},\"type\":\"overlay\",\"roleAttribute\":\"\",\"ariaLabel\":\"Menu\"}'><button aria-haspopup=\"dialog\" aria-label=\"Open menu\" class=\"wp-block-navigation__responsive-container-open\" \n\t\t\t\tdata-wp-on--click=\"actions.openMenuOnClick\"\n\t\t\t\tdata-wp-on--keydown=\"actions.handleMenuKeydown\"\n\t\t\t><svg width=\"24\" height=\"24\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 24 24\"><path d=\"M5 5v1.5h14V5H5z\"><\/path><path d=\"M5 12.8h14v-1.5H5v1.5z\"><\/path><path d=\"M5 19h14v-1.5H5V19z\"><\/path><\/svg><\/button>\n\t\t\t\t<div class=\"wp-block-navigation__responsive-container\"  id=\"modal-1\" \n\t\t\t\tdata-wp-class--has-modal-open=\"state.isMenuOpen\"\n\t\t\t\tdata-wp-class--is-menu-open=\"state.isMenuOpen\"\n\t\t\t\tdata-wp-watch=\"callbacks.initMenu\"\n\t\t\t\tdata-wp-on--keydown=\"actions.handleMenuKeydown\"\n\t\t\t\tdata-wp-on--focusout=\"actions.handleMenuFocusout\"\n\t\t\t\ttabindex=\"-1\"\n\t\t\t>\n\t\t\t\t\t<div class=\"wp-block-navigation__responsive-close\" tabindex=\"-1\">\n\t\t\t\t\t\t<div class=\"wp-block-navigation__responsive-dialog\" \n\t\t\t\tdata-wp-bind--aria-modal=\"state.ariaModal\"\n\t\t\t\tdata-wp-bind--aria-label=\"state.ariaLabel\"\n\t\t\t\tdata-wp-bind--role=\"state.roleAttribute\"\n\t\t\t>\n\t\t\t\t\t\t\t<button aria-label=\"Close menu\" class=\"wp-block-navigation__responsive-container-close\" \n\t\t\t\tdata-wp-on--click=\"actions.closeMenuOnClick\"\n\t\t\t><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 24 24\" width=\"24\" height=\"24\" aria-hidden=\"true\" focusable=\"false\"><path d=\"m13.06 12 6.47-6.47-1.06-1.06L12 10.94 5.53 4.47 4.47 5.53 10.94 12l-6.47 6.47 1.06 1.06L12 13.06l6.47 6.47 1.06-1.06L13.06 12Z\"><\/path><\/svg><\/button>\n\t\t\t\t\t\t\t<div class=\"wp-block-navigation__responsive-container-content\" \n\t\t\t\tdata-wp-watch=\"callbacks.focusFirstElement\"\n\t\t\t id=\"modal-1-content\">\n\t\t\t\t\t\t\t\t<ul class=\"wp-block-navigation__container has-background has-primary-background-color is-responsive items-justified-left md:nfd-order-2 wp-block-navigation\"><li class=\" wp-block-navigation-item wp-block-navigation-link\"><a class=\"wp-block-navigation-item__content\"  href=\"https:\/\/cognitivetxsolutions.com\/staging\/7171\/\"><span class=\"wp-block-navigation-item__label\">Home<\/span><\/a><\/li><li class=\" wp-block-navigation-item wp-block-navigation-link\"><a class=\"wp-block-navigation-item__content\"  href=\"https:\/\/cognitivetxsolutions.com\/staging\/7171\/about\/\"><span class=\"wp-block-navigation-item__label\">The Team<\/span><\/a><\/li><li class=\" wp-block-navigation-item wp-block-navigation-link\"><a class=\"wp-block-navigation-item__content\"  href=\"https:\/\/cognitivetxsolutions.com\/staging\/7171\/sample-page\/\"><span class=\"wp-block-navigation-item__label\"> Support &amp; Resources<\/span><\/a><\/li><li class=\" wp-block-navigation-item wp-block-navigation-link\"><a class=\"wp-block-navigation-item__content\"  href=\"https:\/\/cognitivetxsolutions.com\/staging\/7171\/contact\/\"><span class=\"wp-block-navigation-item__label\">Forms &amp; Services<\/span><\/a><\/li><\/ul>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div><\/nav>\n\n\n<div class=\"md:nfd-hidden nfd-weight-inherit wp-block-buttons is-content-justification-left is-layout-flex wp-container-core-buttons-is-layout-75ad2d25 wp-block-buttons-is-layout-flex\"><\/div>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-28f84493 wp-block-columns-is-layout-flex\">\n<div class=\"negative-right-margin wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:33%\">\n<div class=\"has-base-color has-base-text-color wp-block-group has-primary-background-color has-text-color has-background is-layout-constrained wp-container-core-group-is-layout-d7106b04 wp-block-group-is-layout-constrained\" style=\"padding-top:80px;padding-right:80px;padding-bottom:180px;padding-left:80px\">\n<p class=\"has-medium-font-size\" style=\"font-style:normal;font-weight:600\">TBI Wavier Case Manager Referral Form<\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/docs.google.com\/forms\/d\/e\/1FAIpQLSf0I-tz-s5nqrV1UOTKoLHnNYOErssOrtas32SOHoASPol0NA\/viewform?usp=sf_link\">Click Here<\/a><\/div>\n<\/div>\n\n\n\n<p class=\"has-medium-font-size\" style=\"font-style:normal;font-weight:600\">Innovations Wavier Case Manager Referral Form<\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/docs.google.com\/forms\/d\/e\/1FAIpQLSfPt4GywQx009aZun629QQN9V8zzDEP1jxoau8Z2M2PddkYPw\/viewform?usp=sf_link\">Click Here<\/a><\/div>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center has-secondary-foreground-color has-secondary-background-background-color has-text-color has-background is-layout-flow wp-block-column-is-layout-flow\" style=\"padding-top:100px;padding-right:15%;padding-bottom:100px;padding-left:15%\">\n<h1 class=\"wp-block-heading has-text-align-center has-base-color has-primary-background-color has-text-color has-background has-link-color has-large-font-size wp-elements-2891e110787f88faf83700a9918e0837\"><strong>Services Provided<\/strong><\/h1>\n\n\n\n<ul class=\"wp-block-list\">\n<li class=\"has-large-font-size\">Cognitive Speech &amp; Language Services<\/li>\n\n\n\n<li class=\"has-large-font-size\">Behavioral\/Psychology Services<\/li>\n\n\n\n<li class=\"has-large-font-size\">Dietitian Services<\/li>\n<\/ul>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-28f84493 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<div class=\"wp-block-jetpack-slideshow aligncenter\"><div data-autoplay=\"true\" data-delay=\"5\" data-effect=\"slide\"><div class=\"wp-block-jetpack-slideshow_container swiper-container\"><ul class=\"wp-block-jetpack-slideshow_swiper-wrapper swiper-wrapper\"><li class=\"wp-block-jetpack-slideshow_slide swiper-slide\"><figure><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"1275\" height=\"1649\" alt=\"\" class=\"wp-block-jetpack-slideshow_image wp-image-250\" 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sizes=\"(max-width: 1000px) 100vw, 1000px\" \/><\/figure><\/li><li class=\"wp-block-jetpack-slideshow_slide swiper-slide\"><figure><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"1275\" height=\"1649\" alt=\"\" class=\"wp-block-jetpack-slideshow_image wp-image-249\" data-id=\"249\" src=\"https:\/\/i0.wp.com\/cognitivetxsolutions.com\/staging\/7171\/wp-content\/uploads\/2024\/05\/Beyond-The-Clinic-Walls-Flyer-page-2-4.jpg?resize=1275%2C1649&#038;ssl=1\" srcset=\"https:\/\/i0.wp.com\/cognitivetxsolutions.com\/staging\/7171\/wp-content\/uploads\/2024\/05\/Beyond-The-Clinic-Walls-Flyer-page-2-4.jpg?w=1275&amp;ssl=1 1275w, https:\/\/i0.wp.com\/cognitivetxsolutions.com\/staging\/7171\/wp-content\/uploads\/2024\/05\/Beyond-The-Clinic-Walls-Flyer-page-2-4.jpg?resize=232%2C300&amp;ssl=1 232w, https:\/\/i0.wp.com\/cognitivetxsolutions.com\/staging\/7171\/wp-content\/uploads\/2024\/05\/Beyond-The-Clinic-Walls-Flyer-page-2-4.jpg?resize=792%2C1024&amp;ssl=1 792w, https:\/\/i0.wp.com\/cognitivetxsolutions.com\/staging\/7171\/wp-content\/uploads\/2024\/05\/Beyond-The-Clinic-Walls-Flyer-page-2-4.jpg?resize=768%2C993&amp;ssl=1 768w, https:\/\/i0.wp.com\/cognitivetxsolutions.com\/staging\/7171\/wp-content\/uploads\/2024\/05\/Beyond-The-Clinic-Walls-Flyer-page-2-4.jpg?resize=1188%2C1536&amp;ssl=1 1188w\" sizes=\"(max-width: 1000px) 100vw, 1000px\" \/><\/figure><\/li><\/ul><a class=\"wp-block-jetpack-slideshow_button-prev swiper-button-prev swiper-button-white\" role=\"button\"><\/a><a class=\"wp-block-jetpack-slideshow_button-next swiper-button-next swiper-button-white\" role=\"button\"><\/a><a aria-label=\"Pause Slideshow\" class=\"wp-block-jetpack-slideshow_button-pause\" role=\"button\"><\/a><div class=\"wp-block-jetpack-slideshow_pagination swiper-pagination swiper-pagination-white\"><\/div><\/div><\/div><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-group is-layout-constrained wp-block-group-is-layout-constrained\">\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-28f84493 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-constrained wp-block-column-is-layout-constrained\">\n<h2 class=\"wp-block-heading has-text-align-center\"><img decoding=\"async\" style=\"width: 40px;\" src=\"https:\/\/cognitivetxsolutions.com\/staging\/7171\/wp-content\/themes\/yith-wonder\/assets\/images\/demo-content\/phone-handset-black.svg\" alt=\"\"> 919-740-2383<\/h2>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\">\n<figure class=\"wp-block-image size-full\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"380\" height=\"214\" src=\"https:\/\/i0.wp.com\/cognitivetxsolutions.com\/staging\/7171\/wp-content\/uploads\/2024\/03\/IMG_0967-6.png?resize=380%2C214&#038;ssl=1\" alt=\"\" class=\"wp-image-145\" srcset=\"https:\/\/i0.wp.com\/cognitivetxsolutions.com\/staging\/7171\/wp-content\/uploads\/2024\/03\/IMG_0967-6.png?w=380&amp;ssl=1 380w, https:\/\/i0.wp.com\/cognitivetxsolutions.com\/staging\/7171\/wp-content\/uploads\/2024\/03\/IMG_0967-6.png?resize=300%2C169&amp;ssl=1 300w\" sizes=\"auto, (max-width: 380px) 100vw, 380px\" \/><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\">\n<ul class=\"is-style-logos-only wp-block-social-links aligncenter has-huge-icon-size has-icon-color is-content-justification-center is-layout-flex wp-container-core-social-links-is-layout-a89b3969 wp-block-social-links-is-layout-flex\"><li style=\"color:#404040;\" class=\"wp-social-link wp-social-link-mail has-foreground-color wp-block-social-link\"><a rel=\"noopener nofollow\" target=\"_blank\" href=\"mailto:&#106;k&#115;&#112;ee&#099;&#104;3&#064;&#103;&#109;ai&#108;&#046;&#099;o&#109;\" 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9.9v-7H7.9V12h2.5V9.8c0-2.5 1.5-3.9 3.8-3.9 1.1 0 2.2.2 2.2.2v2.5h-1.3c-1.2 0-1.6.8-1.6 1.6V12h2.8l-.4 2.9h-2.3v7C18.3 21.1 22 17 22 12c0-5.5-4.5-10-10-10z\"><\/path><\/svg><span class=\"wp-block-social-link-label screen-reader-text\">Facebook<\/span><\/a><\/li><\/ul>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>TBI Wavier Case Manager Referral Form Innovations Wavier Case Manager Referral Form Services Provided<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"nf_dc_page":"contact","om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"class_list":["post-6","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - 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